This study examined the association between oral candidiasis in elderly users and nonusers of prosthesis and its predisposing factors. To this end, we performed a cross-sectional study where saliva samples from 48 patients were collected they used prosthesis and 43 patients (control group) who did not use. Among the 91 patients, Candida spp were isolated in 40 (83.3%) who used prosthesis and in 23 (53.5%) in the control group. A statistically significant association was determined between the two groups, the isolation of yeasts and dental prosthesis (p < 0.05, OR = 4.3). The most common etiological agent was Candida albicans (37 isolates), with 23 (62.2%) in the denture group and 14 (37.8%) (control group). Among patients who presented clinical manifestations of oral candidiasis (n = 24), 83.3% (n = 20) belonged to the group that wore dentures, while only 16.7% (n = 4) belonged to the control group. Elderly patients with diabetes had 4.4 times higher estimated risk of developing oral candidiasis when compared with individuals without this condition. There was no statistically significant association between being user prostheses and have diabetes with the onset of candidiasis. No statistically significant association was determined between xerostomia, use of prosthesis and oral candidiasis. The use of prosthetics and poor oral hygiene in elderly patients predisposes to the development of oral candidiasis.
Abstract. We report the first case of fungemia caused by Paracoccidioides lutzii in a 51-year-old male farm worker from the central-west region of Brazil. The fungus was isolated from blood cultures and the species was confirmed by phylogenetic identification. Despite specific treatment and intensive care, the patient died 39 days after admission.
RESUMOEsses fungos são comumente encontrados no solo e nas folhas secas do chão, sendo a infecção decorrente da implantação de esporos inalados, juntamente com partículas do solo, sobre a mucosa nasal. Sabe-se que in vitro o fungo é capaz de produzir várias enzimas tais como elastases, esterases, colagenases e lípases, as quais podem estar envolvidas na patogênese da infecção 3 . A entomoftoromicose causada por C. coronatus manifesta-se clinicamente como um infiltração granulomatosa crônica da mucosa nasal, estendendo-se para o tecido subcutâneo e pele da face contígua, sem delimitação de seu crescimento. Essa expansão tumoral produz sintomas como obstrução nasal e dor local, sendo freqüente a sinusite bacteriana, conseqüente ao processo obstrutivo presente. Chama a atenção, entretanto, a grande freqüência de deformidade facial, resultante de infiltração e edema da região 3 4 . O diagnóstico é geralmente confirmado por cultura e pela visualização microscópica do fungo em material obtido da lesão. Histopatologicamente, a doença se caracteriza por infiltrado granulomatoso do tecido subcutâneo, contendo material eosinofílico hialino, no qual são visualizadas hifas grandes, não septadas (ou raramente septadas) de C. coronatus 4 .Descreve-se aqui o primeiro caso de zigomicose nasofacial causada por C. coronatus em Mato Grosso. RELATO DO CASOJASF, 37 anos, pedreiro, residente em Sinop-MT, desde 1978. Relatou trauma facial com fratura de osso nasal em 1992. Há 2 anos vem apresentando obstrução nasal e epistaxe discreta e esporádica. Evoluiu com aumento progressivo de nódulos subcutâneos duros e pouco dolorosos no dorso do nariz e nas regiões paranasal e frontal. Durante esse período, foi submetido a exaustivo processo de investigação, incluindo biópsia da lesão em região infra-orbitária direita, com diagnóstico de processo inflamatório crônico granulomatoso tipo corpo estranho; porém sem conclusão etiológica. Recebeu vários tipos de tratamento empíricos, sem contudo apresentar melhora. Recentemente,
Clinical Paracoccidioides spp. isolates from patients with paracoccidioidomycosis (PCM) in Mato Grosso, Brazil exhibit different patterns of serologic reactivity. The results observed for reactions of radial immunodiffusion against the commonly used exoantigens containing a 43-kDa glycoprotein (gp43) suggest that this fungus exhibits major antigenic variability by geographic region. There is a phylogenetic gap between Paracoccidioides spp. isolates among different regions of Latin America. In particular, those from the central region of Brazil (i.e. Mato Grosso state) exhibit a lower rate of genetic similarity. We aimed at investigating the phylogenetic classification of clinical isolates of Paracoccidioides spp. in Central Brazil and the different antigenic profiles that produce. Exoantigens were obtained from five clinical isolates: two P. brasiliensis (Pb166 and Pb2880) and three P. lutzii (PL2875, PL9840, and PL2912). The protein/glycoprotein profiles of P. lutzii exoantigens were different from each other. Isolate PL9840 exhibited the most distinct bands, and isolates PL2875 and PL2912 exhibited more diffuse bands and a very intense band between 50 and 60 kDa. P. brasiliensis isolates had similar protein profiles, exhibiting a low-intensity band at 220 kDa and a diffuse band between 50 and 60 kDa. P. lutzii isolates exhibit high species-specific antigen variability, which we have already been assessed in proteomic studies.
Introduction: Cryptococcosis is a systemic fungal infection that affects humans and animals, mainly due to Cryptococcus neoformans and Cryptococcus gattii. Following the epidemic of acquired immunodeficiency syndrome (AIDS), fungal infections by C. neoformans have become more common among immunocompromised patients. Cryptococcus gattii has primarily been isolated as a primary pathogen in healthy hosts and occurs endemically in northern and northeastern Brazil. We to perform genotypic characterization and determine the in vitro susceptibility profile to antifungal drugs of the Cryptococcus species complex isolated from HIV-positive and HIV-negative patients attended at university hospitals in Cuiabá, MT, in the Midwestern region of Brazil. Methodology: Micromorphological features, chemotyping with canavanine-glycine-bromothymol blue (CGB) agar and genotyping by URA5-RFLP were used to identify the species. The antifungal drugs tested were amphotericin B, fluconazole, flucytosine, itraconazole and voriconazole. Minimum inhibitory concentrations (MICs) were determined according to the CLSI methodology M27-A3. Results: Analysis of samples yelded C. neoformans AFLP1/VNI (17/27, 63.0%) and C. gattii AFLP6/VGII (10/27, 37.0%). The MICs ranges for the antifungal drugs were: amphotericin B (0.5-1 mg/L), fluconazole (1-16 mg/L), flucytosine (1-16 mg/L), itraconazole (0.25-0.12 mg/L) and voriconazole (0.06-0.5 mg/L). Isolates of C. neoformans AFLP1/VNI were predominant in patients with HIV/AIDS, and C. gattii VGII in HIV-negative patients. The genotypes identified were susceptible to the antifungal drugs tested. Conclusion: It is worth emphasizing that AFLP6/VGII is a predominant genotype affecting HIV-negative individuals in Cuiabá. These findings serve as a guide concerning the molecular epidemiology of C. neoformans and C. gattii in the State of Mato Grosso.
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